The invention relates to a device for conditioning an organic ligament to be implanted, in particular a ligament as a cruciate ligament replacement.
In cruciate ligament plasty as a rule organic ligaments from the body of the patient are applied. These ligaments with a re-loading after operation often experience a length change. This may lead to renewed instabilities of the knee joint. Therefore one strives to condition the ligament before implantation, i.e. the ligament is preoperatively stretched to a permanent length so that a later length change may not occur.
It is known that the ligament to be implanted is stretched by the operator directly before or during the operation by the application of force, wherein one assumes that the ligament loses the property of extending later. With this the ligament is, for example, tied together into a loop and received between both hands or index fingers and stretched.
With this there is the disadvantage that the manual stretching among other things depends individually on the condition of the operator, so that inasmuch as this is concerned there are to be expected no reproducible and exact stretching results, not least because these also depend on the nature of the respective ligament itself.
It is therefore the object of the invention to provide a device with which it is possible to simulate the procedure of the manual stretching and to carry out a permanent extension of the ligament, which can be estimated in its extent, so that the intensity of the conditioning may also be carried out with differently stable ligaments in a reproducible manner.
For achieving this object the device for conditioning a ligament according to the invention comprises a first and a second receiving element for receiving and for tensioning the ligament at two spaced points, wherein the first receiving element is connected to means for the periodic, and with respect to the ligament, translatory adjustment of the first receiving element.
The strip is thus accommodated at the receiving elements in the device and subjected mechanically to a preferably adjustable periodic alternating load for so long until one finally may assume from experience values that the ligament is sufficiently stretched, and after the implantation, e.g. as a cruciate ligament replacement, is no longer extended.
The means for the periodic adjustment of the receiving element comprises a disk which is driven by a motor and onto which a crank is arranged eccentrically and linkingly with one of its ends. At the other end of the crank there is fastened the receiving element. With this conception there is thus effected the periodic stretching of the ligament with an eccentric drive.
The two receiving elements are usefully formed as a hook into which the ligament in the form of a loop may be loosely hung. The one hook which forms the second receiving element is arranged on a linearly displaceable unit. This unit comprises an axially displaceably mounted rod which is connected to an elastic element which is rigidly arranged on it and which may be a helical spring. With this it is the case of a compression spring which holds the ligament tensioned, wherein the rod in operation of the device is adjusted against or with the action of the spring according to the position of the eccentric.
For the reproducibility of the conditioning it is important that the force which the device exerts on the tensioned ligament be measured and where appropriate may also be adjusted. It is therefore further envisaged that the mentioned displaceable unit comprises means for measuring the maximum force exerted by the elastic element onto the rod. These force measuring means, in a simple embodiment, consist of a sliding ring placed on a cylindrical part as well as an abutment for the sliding ring.
Furthermore, for the purpose of adjustability to various length ligaments or ligament loops, the device comprises further adjusting means for adjusting the distance between the two receiving elements or hooks.
For an exact adjusting of the ligament loading the linearly displaceable unit has tensioning means for setting and fixing the axial position of the mentioned rod relative to this unit. A simple embodiment thereby results with the use of a screw and a nut as a tensioning means.
With the suggested device it is possible, in contrast to a conditioning by hand, to be able to achieve a reproducible and, according to demand, an exact and sufficient conditioning of the ligament. In particular, on account of the previous alternating loadings, it may be insured that the ligament has experienced its largest possible length change before the implantation so that damaging length changes on account of natural loading may be ruled out later after implantation.